(Graphic via English Wikimedia)

CLIMATE CHANGE can dramatically impact our mental health. We are all witness to the vast number of climate-related disasters happening throughout the world, from fires in Canada to Hawaii.

In addition to their devastating impact on our physical health, communities, and economy, the fallout from these traumas also has a significant negative effect on mental health. As psychiatrists, our first goal is to highlight this connection. Our second is to explore solutions. 

We are bombarded by “climate change” facts. Currently, the world is 1.1°C hotter than pre-industrial times. More than five of the past 20 years have broken the hottest year on record, and this July 2023 marks the warmest month since 1880.

Governmental and non-governmental agencies are naming climate change a major threat of our generation and calling for immediate action to avert the worst consequences by the end of the century. These facts are overwhelming and lead to a sense of climate dread which has been termed “eco-anxiety” or “climate distress.” However, these terms do not capture the full scope of the many ways that environmental crises impact mental health. Here, we apply the term enviro-mental health – variations of which recently have been introduced into this conversation – to describe how the health of the environment affects how we think, feel, and behave through the lenses of psychology and biology.

The immediate effects of climate change on our emotional state are particularly evident for people responding to climate traumas, such as hurricanes, flooding, or forest fires. In these populations, we see increased rates of posttraumatic stress disorder, as well as increased levels of substance use and domestic violence. 

For children, climate-related familial disruption, and displacement, can lead to increased challenges of regulating emotions later in life. There is also a level of increased prenatal stress for expecting mothers during these climate traumas that can lead to pregnancy complications resulting in mental health ramifications for their children.

While some communities have thus far been spared from directly experiencing climate disasters, they nevertheless can experience significant eco-anxiety that comes from thinking about what our future holds in store.

Young people are especially impacted by this climate distress. In a landmark Lancet study, 10,000 surveys of young people were collected from around the world to examine their concerns about climate change. The results are jarring — 59 percent are “very” to “extremely” worried about climate change, 45 percent think climate change affects their daily lives, 75 percent think their future is “frightening,” over half think “humanity is doomed,” and 40 percent are even hesitant to have children. Climate distress is not just a concern for a few people – for many, it is the norm.

Additionally, the climate can impact our behavioral health on a biological level. For example, heat waves are associated with increased aggressive behavior, such as violent crimes, as well as increased incidence of suicide. Warm seasons are often associated with worse outcomes of many psychiatric diseases, including self-harm, episodes of mania, as well as hospital admissions for posttraumatic stress disorder.

Psychiatrists are working to understand this association and have several hypotheses in addition to the impact of climate-related stressors. First, patients who suffer from mood and psychotic disorders have trouble regulating their body temperature. For example, patients with depression, bipolar disorder, and panic disorder all have a decreased ability to sweat, which is essential for controlling body heat. Also, many of the medications used to treat patients with mental health disorders can impair their body temperature regulation. Finally, chemicals in the brain, like serotonin, that control our emotions may also be sensitive to temperature.  

Lastly, there are several ways that climate change can indirectly affect our mental health. Air pollution from fossil fuel combustion and forest fires has been associated with increased rates of attention deficit hyperactivity disorder and neurodevelopmental disorders. Also, increased atmospheric carbon dioxide can decrease crop micronutrients in our food, the reduction of which has been associated with psychiatric and developmental disorders. Finally, hotter temperatures can lead to increased levels of certain pests, such as ticks, that carry diseases that can affect the brain. These examples are just a few of the indirect environmental changes that we are beginning to study in the context of mental health.

So, what can we do? The mantra “don’t worry alone” is a good place to start — mental health providers are already working to support people undergoing climate traumas and distress. Reach out for help and talk to others about how you are feeling. This may be in the form of a friend, or a climate aware therapist/psychiatrist who can address your concerns. 

Some studies have shown that getting involved in activism or advocacy can help address feelings of climate distress. Other studies point out that nature itself can be therapeutic. Getting outside, sitting by the ocean, or walking along a tree-lined street can decrease anxiety, increase the relaxation response, and increase one’s connection to the world around us. This is even more important for children, because a generation that loves nature will help work to protect it.

The American Psychiatric Association’s Committee on Climate Change and Mental Health, and non-profits like the Climate Psychiatry Alliance and Climate Psychology Alliance are working to provide patients and health care workers with resources to address the impacts of climate on mental health. For providers, a more widespread understanding of the ways in which the environmental conditions can affect mental health and illness can enhance prevention, detection, and treatment. 

Our mental health is shaped by our environment in many ways, just as we shape the environment, in many cases for the worse. Enviro-mental health considers the many impacts of the earth’s environment on the social, emotional, and biological components of our mental health.

It is critical that we recognize this connection and try to mitigate the fallout. Unfortunately, the haze of Canadian forest fires represents an ongoing trend. People around the world are uncertain about our planet’s future and are anxiously waiting for the smoke to clear. It is therefore fundamental that we accept that the environment impacts our mental health, and as we work to improve the world outside, we need to pay close attention to its impact on the world within.  

Jeremy Wortzel is a resident in psychiatry and David Silbersweig is chair of the department of psychiatry at Brigham and Women’s Hospital.